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Diagnostics
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Advanced Diagnostic and Interventional Radiology in Urology
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Advanced Diagnostic and Interventional Radiology in Urology

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (31 March 2024) | Viewed by 18738

Special Issue Editors

Dr. Chiara Martini

E-Mail Website
Guest Editor
Department of Radiology, Parma University Hospital, Via Gramsci 14, 43125 Parma, Italy
Interests: cardiac imaging; pulmonary imaging; cardiac computed tomography; cardiac magnetic resonance; post-processing; artificial intelligence
Special Issues, Collections and Topics in MDPI journals
Dr. Massimo De Filippo

E-Mail Website
Guest Editor
Department of Medicine and Surgery, Parma, Italy
Interests: urology imaging; urology

Special Issue Information

Dear Colleagues, 

This Special Issue showcases recent advances in concomitant diagnostic and interventional radiology in urology. In particular, selected original research articles are included that highlight the use of advanced to better characterize morphological and functional characterization in multimodality diagnostic techniques. The technological advancement of imaging, post-processing and interventional equipment. These techniques will likely become essential tools to assist radiologist interpretations and interventions as they are eventually incorporated into the workflow. Potential applications that are of research interest include implementing automated anatomy and interventional systems; segmentation and measurement for diagnosis; surgery application at the state of art, in order to predict optimal treatment selection and assess treatment response.

Dr. Chiara Martini
Dr. Massimo De Filippo
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

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Published Papers (7 papers)

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Research

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9 pages, 255 KiB  
Article
The Diagnostic Efficacy of and Requirement for Postnatal Ultrasonography Screening for Congenital Anomalies of the Kidney and Urinary Tract
by Abdulgani Gulyuz and Mehmet Tekin
Diagnostics 2023, 13(19), 3106; https://doi.org/10.3390/diagnostics13193106 - 30 Sep 2023
Viewed by 1333
Abstract
Background: We aimed to investigate the efficacy of postnatal ultrasonography in detecting congenital anomalies of the kidneys and urinary tract in term infants without prenatal history of congenital anomalies of the kidneys and urinary tract. Methods: In this retrospective cohort study, we reviewed [...] Read more.
Background: We aimed to investigate the efficacy of postnatal ultrasonography in detecting congenital anomalies of the kidneys and urinary tract in term infants without prenatal history of congenital anomalies of the kidneys and urinary tract. Methods: In this retrospective cohort study, we reviewed the records of term infants between six weeks and three months of age who underwent urinary tract ultrasonography during routine pediatric care. Results: Congenital anomalies of the kidneys and urinary tract were detected on prenatal ultrasonography in 75 of the 2620 patients included in the study. Congenital anomalies of the kidneys and urinary tract were detected via postnatal USG in 46 (1.8%) of 2554 patients without anomalies on prenatal USG screening. The most common anomaly was hydronephrosis (69.6%). Thirty-two cases of hydronephrosis, three cases of renal agenesis, four cases of horseshoe kidney, one case of MCDK, and two cases of duplex systems which were not detected on prenatal USG were detected on postnatal USG. On the other hand, 29 (1.1%) cases with mild or moderate hydronephrosis on prenatal ultrasonography did not have hydronephrosis on postnatal ultrasonography. Conclusions: In our study, approximately one-third of the cases of hydronephrosis, unilateral renal agenesis, duplex systems, horseshoe kidney, and ectopic kidney were not detected in prenatal ultrasonography screening. Therefore, we believe that in addition to prenatal ultrasonography screening, postnatal ultrasonography screening of all children for urinary tract anomalies would be beneficial. Full article
(This article belongs to the Special Issue Advanced Diagnostic and Interventional Radiology in Urology)
10 pages, 2662 KiB  
Article
Single-Center Experience with Swiss LithoClast® Trilogy for Kidney Stones
by Victor-Mihail Cauni, Florin Tanase, Bogdan Mihai, Gabriel-Petre Gorecki, Liana Ples, Romina-Marina Sima and Cristian Persu
Diagnostics 2023, 13(8), 1372; https://doi.org/10.3390/diagnostics13081372 - 8 Apr 2023
Cited by 2 | Viewed by 1770
Abstract
Introduction: PCNL remains the gold standard for larger kidney stones. Reducing the operating time of PCNL and its complication rate seems to be the next logical step in optimizing this classical technique. To achieve these objectives, some new methods of lithotripsy emerge. We [...] Read more.
Introduction: PCNL remains the gold standard for larger kidney stones. Reducing the operating time of PCNL and its complication rate seems to be the next logical step in optimizing this classical technique. To achieve these objectives, some new methods of lithotripsy emerge. We present the data of a single, high-volume, academic center with combined ultrasonic and ballistic lithotripsy in PCNL using the Swiss LithoClast® Trilogy device. Materials and Methods: We designed a prospective, randomized study including patients who underwent PCNL or miniPerc with lithotripsy using the new EMS Lithoclast Trilogy or EMS Lithoclast Master. The procedure was carried out with all patients in prone position, by the same surgeon. The working channel size was 24 Fr–15.9 Fr. We evaluated the stones’ features, operative time, fragmentation time, complications, stone clearance rate and stone-free rate. Results: Our study included 59 patients, 38 females and 31 males, of an average age of 54.5 years old. The Trilogy group included 28 patients and the comparator included 31 patients. Urine culture was positive in seven cases which required seven days of antibiotics. The mean stone diameter was 35.6 mm with a mean Hounsfield unit (HU) of 710.1. The average number of stones was 2.08 (6 complete staghorn stones and 12 partial staghorn stones). A total of 13 patients presented a JJ stent (46.4%). We found a very significant difference in all the parameters favoring the Trilogy device. The most important result in our opinion is the probe active time, which was almost six times shorter in the Trilogy group. The stone clearance rate was about double in the Trilogy group, leading to shorter overall and intra-renal operating times. The overall complication rate was 17.9% in the Trilogy group and 23% in the Lithoclast Master group. The mean hemoglobin drop was 2.1 g/dL with a mean creatinine rise of 0.26 mg/dL. Conclusions: Swiss LithoClast® Trilogy, a device combining ultrasonic and ballistic energy, is a safe and efficient method of lithotripsy for PCNL, proving statistically significant benefits over its predecesor. It can achieve the goal of reducing complication rates and operative times for PCNL. Full article
(This article belongs to the Special Issue Advanced Diagnostic and Interventional Radiology in Urology)
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11 pages, 1355 KiB  
Article
Mini-Perc for Renal Stones—A Single Center Experience and Literature Review
by Victor-Mihail Cauni, Mihai Dragutescu, Bogdan Mihai, Gabriel-Petre Gorecki, Liana Ples, Romina-Marina Sima and Cristian Persu
Diagnostics 2023, 13(6), 1083; https://doi.org/10.3390/diagnostics13061083 - 13 Mar 2023
Viewed by 2461
Abstract
Aim: The aim of this study was to analyze the outcomes of miniaturized nephrolithotomy (mini-perc) in the management of renal stones with a diameter smaller than 20 mm. Materials and Methods: We retrospectively reviewed the records of 102 patients who underwent mini-perc between [...] Read more.
Aim: The aim of this study was to analyze the outcomes of miniaturized nephrolithotomy (mini-perc) in the management of renal stones with a diameter smaller than 20 mm. Materials and Methods: We retrospectively reviewed the records of 102 patients who underwent mini-perc between March 2015 and March 2020 in our department. The primary objective was the stone-free rate, but we also analyzed the retreatment rate, complications, hospital stay, operative time and reduction in hemoglobin level. All these patients had this technique as their first-line treatment, in a prone position, using a 16 Fr sheath size. Data were compared to a series of patients from the literature, treated with conventional PCNL. Results: The patients had calculus limited to either a single calyx or just extending to the renal pelvis, and stone size was less than 20 mm in its maximal dimension. The intrarenal stone location was in the upper calyx in 7 cases, middle calyx in 20 cases and lower calyx in 46 cases, and there were 29 patients with renal pelvis stone. The male to female ratio was 1.5:1, and the median age was 48.4 years. The average stone size was 17.4 mm in diameter (ranging between 9 and 20 mm) and all cases underwent Ho-YaG laser lithotripsy, ballistic energy and combined ultrasonic and ballistic lithotripsy. At the end of the procedure, an antegrade double J stent was placed under fluoroscopy for a maximum of 2 weeks in 42 cases, while 9 cases needed a nephrostomy tube 12–14 F. A total of 51 cases were totally tubeless. Our median operative time was 61 min (ranging from 35 to 75 min). The median hospitalization stay was 3.8 days. The stone free rate was 90.1% after one procedure, only nine (8.8%) cases needed a “second look” flexible ureteroscopy, and the final stone-free rate was 98% (absence of detectable calculi on ultrasound, KUB or non-contrast CT scan). The overall complication rate was 6.86% (Clavien classification I—57.14%; II—28.5%; III—14.2%), while no Clavien IV or V complications were reported. No patient required a blood transfusion, and mean hemoglobin loss was 0.81 mg/dL. Overall, our results are better than similar data for conventional PCNL in the literature. Conclusions: The “mini-perc” technique is an effective procedure for the treatment of the renal lithiasis that is less or equal to 2 cm. The results demonstrated that this minimally invasive technique is associated with a higher stone-free rate and minimal complications. Full article
(This article belongs to the Special Issue Advanced Diagnostic and Interventional Radiology in Urology)
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Review

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14 pages, 7200 KiB  
Review
Radiofrequency Ablation, Cryoablation, and Microwave Ablation for the Treatment of Small Renal Masses: Efficacy and Complications
by Lorenzo Bertolotti, Maria Vittoria Bazzocchi, Enrico Iemma, Francesco Pagnini, Francesco Ziglioli, Umberto Maestroni, Annalisa Patera, Matteo Pio Natale, Chiara Martini and Massimo De Filippo
Diagnostics 2023, 13(3), 388; https://doi.org/10.3390/diagnostics13030388 - 20 Jan 2023
Cited by 16 | Viewed by 5053
Abstract
Over the last two decades the detection rate of small renal masses has increased, due to improving diagnostic accuracy, and nephron-sparing treatments have become the first-choice curative option for small renal masses. As a minimally invasive alternative, thermal ablation has increased in popularity, [...] Read more.
Over the last two decades the detection rate of small renal masses has increased, due to improving diagnostic accuracy, and nephron-sparing treatments have become the first-choice curative option for small renal masses. As a minimally invasive alternative, thermal ablation has increased in popularity, offering a good clinical outcome and low recurrence rate. Radiofrequency ablation, Cryoablation, and Microwave ablation are the main ablative techniques. All of them are mostly overlapping in term of cancer specific free survival and outcomes. These techniques require imaging study to assess lesions features and to plan the procedure: US, CT, and both of them together are the leading guidance alternatives. Imaging findings guide the interventional radiologist in assessing the risk of complication and possible residual disease after procedure. The purpose of this review is to compare different ablative modalities and different imaging guides, underlining the effectiveness, outcomes, and complications related to each of them, in order to assist the interventional radiologist in choosing the best option for the patient. Full article
(This article belongs to the Special Issue Advanced Diagnostic and Interventional Radiology in Urology)
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15 pages, 260 KiB  
Review
Pulsed Radiofrequency Ablation for Orchialgia—A Literature Review
by Meshari A. Alzahrani, Omar Safar, Muath Almurayyi, Abdulaziz Alahmadi, Abdulrahman M. Alahmadi, Muhannad Aljohani, Abdalah E. Almhmd, Khaled Nasser Almujel, Bader Alyousef, Hussam Bashraheel, Feras Badriq and Abdulaziz Almujaydil
Diagnostics 2022, 12(12), 2965; https://doi.org/10.3390/diagnostics12122965 - 27 Nov 2022
Viewed by 2250
Abstract
Pulsed radiofrequency, short bursts of radiofrequency energy, has been used by pain practitioners as a non- or minimally neurodestructive technique, an alternative to radiofrequency heat lesions. The clinical advantages and mechanisms of this treatment remain unclear. To review the current clinical implication of [...] Read more.
Pulsed radiofrequency, short bursts of radiofrequency energy, has been used by pain practitioners as a non- or minimally neurodestructive technique, an alternative to radiofrequency heat lesions. The clinical advantages and mechanisms of this treatment remain unclear. To review the current clinical implication of the pulsed radiofrequency technique for male patients with chronic scrotal pain. We systematically searched the English literature available at the EMBASE, MEDLINE/PubMed, Google Scholar, and Cochrane Library from inception to 22 November 2022. Only reports on a pulsed radiofrequency application on male patients with chronic scrotal pain were included. The final analysis yielded six reports on the clinical use of pulsed radiofrequency applications in male patients with chronic scrotal pain: six full publications, three case reports, one case series, one prospective uncontrolled pilot study, and one prospective randomized, controlled clinical trial. The accumulation of these data shows that using pulsed radiofrequency generates an increasing interest in pain physicians, radiologists, and urologists for managing chronic scrotal pain. No side effects related to the pulsed radiofrequency technique were reported to date. Further research on the clinical and biological effects is justified. Large sample sizes and randomized clinical trials are warranted. Full article
(This article belongs to the Special Issue Advanced Diagnostic and Interventional Radiology in Urology)

Other

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9 pages, 924 KiB  
Case Report
Urinary Bladder Hemangioma Successfully Treated by Angioembolization with Long-Term Follow-Up: Case Report and Literature Review
by Omar Safar, Abdulhadi Al-Qahtani and Saad Al-Qahtani
Diagnostics 2023, 13(5), 875; https://doi.org/10.3390/diagnostics13050875 - 25 Feb 2023
Cited by 2 | Viewed by 2249
Abstract
Hemangiomas are benign blood vessel and capillary tumor growths which are widespread in many organs but extremely rare in the bladder, making up just 0.6% of all bladder tumors. To the best of our knowledge, few cases of bladder hemangioma are associated with [...] Read more.
Hemangiomas are benign blood vessel and capillary tumor growths which are widespread in many organs but extremely rare in the bladder, making up just 0.6% of all bladder tumors. To the best of our knowledge, few cases of bladder hemangioma are associated with pregnancy in the literature, and no bladder hemangiomas have been discovered incidentally after abortion. The use of angioembolization is well established; however, postoperative follow-up is crucial to identify tumor recurrence or residual disease. Case presentation: In 2013, a 38-year-old female was referred to a urology clinic with an incidental finding after an abortion of a large bladder mass identified incidentally using ultrasound (US). The patient was recommended for CT, which reported a polypoidal hypervascular lesion, as previously described arising from the urinary bladder wall. Diagnostic cystoscopy showed a large, bluish-red, pulsatile, vascularized submucosal mass with large dilated submucosal vessels, a wide-based stalk, and no active bleeding in the posterior wall of the urinary bladder, measuring about 2 × 3 cm, with negative urine cytology. Due to the vascular nature of the lesion and no active bleeding, the decision was made not to biopsy. The patient underwent angioembolization and scheduled for US every six months with regular diagnostic cystoscopy. In 2018, at 5 years of follow-up, the patient developed recurrence after a successful pregnancy. The angiography revealed recanalization of the previously embolized left superior vesical arteries from the anterior division of the left internal iliac artery, resulting in arteriovenous malformation (AVM). The second angioembolization was performed, with the total exclusion of AVM without residual. By the end of 2022, the patient had remained asymptomatic and without recurrence. Conclusion: Angioembolization is a safe treatment technique, minimally invasive, and has less effect on the quality of life, especially in young patients. Long-term follow-up is essential for detecting tumor recurrence or residual disease. Full article
(This article belongs to the Special Issue Advanced Diagnostic and Interventional Radiology in Urology)
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13 pages, 2572 KiB  
Case Report
Urachal Carcinoma, An Unusual Possibility of Hematuria; Case Report and Literature Review
by Răzvan Călin Tiutiucă, Alina Ioana Năstase Pușcașu, Elena Țarcă, Nicoleta Stoenescu, Elena Cojocaru, Laura Mihaela Trandafir, Viorel Țarcă, Dragoș-Viorel Scripcariu and Mihaela Moscalu
Diagnostics 2022, 12(8), 1892; https://doi.org/10.3390/diagnostics12081892 - 4 Aug 2022
Cited by 5 | Viewed by 2513
Abstract
Urachal cancer is very rare, accounting for only 0.5–2% of bladder-associated malignancies and 0.01% of all cancers in adults. It has an insidious appearance, an aggressive behavior and a poor prognosis. The most common symptoms are hematuria and the presence of a palpable [...] Read more.
Urachal cancer is very rare, accounting for only 0.5–2% of bladder-associated malignancies and 0.01% of all cancers in adults. It has an insidious appearance, an aggressive behavior and a poor prognosis. The most common symptoms are hematuria and the presence of a palpable hypogastric mass. The scarcity of cases and the low number of studies carried out explains the lack of an evidence-based management strategy, but it seems that surgical treatment (open, laparoscopy or robot-assisted) represents the gold standard, while neoadjuvant and adjuvant chemotherapy or radiotherapy has a limited impact on overall survival. Since mucinous cystadenocarcinoma of urachal origin is a very uncommon pathological condition the differential diagnosis may be difficult and pathological investigations have to elucidate this disorder. It is worth mentioning the psychological impact on the patient in addition to the medical aspects. A rare condition is associated with heightened risk for mental health and psychosocial difficulties and this must be taken into account in the subsequent follow-up of the patient. In order to increase awareness of this rare entity we report a case of a 40-year-old male with a urachal adenocarcinoma who was treated surgically, with a favorable outcome. We also perform a brief literature review about this type of tumor. Full article
(This article belongs to the Special Issue Advanced Diagnostic and Interventional Radiology in Urology)
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